Clinical Outcomes of Platelet-Rich Plasma in Otology: A Systematic Review of Tympanoplasty, Myringoplasty, and Hearing Loss Management

TL;DR

This review examines how platelet-rich plasma (PRP) affects outcomes in ear surgeries and hearing loss treatment, finding it generally safe and possibly beneficial for healing.

Contribution

A systematic review of PRP's clinical outcomes in otology, highlighting its potential in tympanic membrane repair and SNHL treatment.

Findings

PRP was associated with higher graft uptake and faster healing in myringoplasty/tympanoplasty compared to other methods.

PRP showed comparable or better hearing improvement in SNHL compared to steroids, though evidence is limited.

Postoperative complications were low, and no major safety concerns were identified with PRP use.

Abstract

Platelet-rich plasma (PRP), an autologous concentrate of platelets and growth factors, has been explored as an adjunct in otologic procedures, including tympanoplasty, myringoplasty, and treatment of sudden sensorineural hearing loss (SNHL). This systematic review evaluated reported clinical outcomes associated with PRP in these settings. A literature search was conducted in March 2025 across PubMed, Scopus, Web of Science, EMBASE, and the Cochrane Library. Eligible studies were English-language human studies (2015-2025) with original clinical outcome data from randomized or comparative observational designs. Due to methodological heterogeneity, findings were synthesized narratively. Six studies (n = 349 patients) were included: five addressing tympanic membrane repair and one addressing idiopathic sudden SNHL. In myringoplasty/tympanoplasty-related studies, PRP was generally associated with higher graft uptake and/or faster healing than comparator approaches; where reported, closure outcomes included 85.7% versus 60% in one comparative study, and several studies reported between-group differences with p < 0.05. Reported postoperative complications were low, and no major PRP-related safety concerns were identified in the included studies. In SNHL, one comparative study suggested hearing improvement with intratympanic PRP that was comparable to, or greater than, steroid therapy, but evidence remains limited to short-term follow-up and a small number of studies. Current evidence supports PRP as a feasible and apparently safe adjunct in otologic practice, particularly for tympanic membrane repair. However, certainty regarding the magnitude of benefit and long-term auditory outcomes remains limited by small sample sizes, heterogeneity in PRP preparation/application, and variability in study design. Standardized protocols and larger, well-designed randomized trials are needed.

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